2012 public opinion research: canadian views on electronic health records this study was...
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2012 Public Opinion Research: Canadian Views on Electronic Health RecordsThis study was commissioned by the Canadian Institute for Health Information (CIHI) and Canada Health Infoway.
March 2012
© Harris/Decima
Summary of Objectives• A baseline survey was conducted in 2010 to understand Canadians’ views on
a number of areas:– Situating electronic health records in the health care system;– Understanding the current state of Canadians’ health records;– Gauging awareness and impressions of electronic record transition; and– Determining awareness and impressions of Health System Usage of records.
• The 2012 survey explored the same areas to identify any changes in impressions from 2010.
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Summary of Methodology• A total of 1,010 telephone surveys were completed among Canadian adults,
(excluding the territories) 18 years of age and over– A random sample of Canadians was selected
• All households with a landline had an equal opportunity in participating in the study• The study was not designed to re-contact previous participants. Rather, a “fresh”
sample was pulled• Interviews were conducted between January 31 and February 10, 2012 and
averaged 13 minutes in length• Results from this survey can be considered accurate within a margin of error
of +/-3.1%, 19 times out of 20– Larger for sub-samples
• Data results are weighted to reflect the population– Base sizes (n) indicated below the data are unweighted numbers
• Don’t know responses are reported if 5% or greater
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Summary of Methodology (2)• The table below highlights the completions by region.
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Region Sample Size (Unweighted)
Atlantic Canada 101
Quebec 251
Ontario 329
Manitoba/Saskatchewan 103
Alberta 100
British Columbia 126
Total 1,010
Key Findings
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Key Findings from the ResearchOverall, the data show positive movement in a number of key areas:
• There has been an increase in receptivity to the idea of converting records from paper to electronic (up 11 points to 85% very good or good idea).
• Moreover, the proportion of Canadians who express some concern about the idea of electronic records has decreased.
• More Canadians in 2012 believe that their physician is using electronic records as compared to 2010 (50% vs. 38%).
• The data suggests that Canadians’ understanding of an electronic health record as a tool that goes beyond record keeping has increased. Additionally, there is a sense that electronic records would have some impact on patient care and the health care system.
• While there is comfort with health system usage of health information, there are two key considerations:– The data indicates that a majority of Canadians would insist on disclosure and consent when their
information would be used for this purpose.– The information would NOT be shared with private organizations such as insurance or pharmaceutical
companies
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Situating Electronic Health Records
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Key Findings: Situating Electronic Health Records (EHRs)• Initially, the survey suggests that EHRs are not a top-of-mind issue among Canadians
for the health care system.– Only 1 person in the full sample named electronic records as the top issue
• Instead, Canadians identify a number issues facing the Canadian health care system relating predominantly to availability/access of resources (25%) or speed of care (22%).
© Harris/Decima
Don't know
Other
Health Records/Electronic Health Records
Availability of/Access to equipment
Costs
Wait times
Availability of/Access to Doctors/Nurses
0% 20% 40% 60%
9%
33%
1%
3%
10%
18%
26%
8%
32%
2%
10%
22%
25%
2012 2010
<1%
Resources and access continue to dominate the health care agenda
Base: All respondents (n=1,010)
Q1. Overall, what would you say is the most important issue facing the Canadian Health Care system today – in other words, the one that concerns you most?
© Harris/Decima
Current State of Medical Records
© Harris/Decima
Key Findings: Current State of Medical Records• Similar to the findings in 2010, a majority have most or all of their medical records in
one place and are at least fairly easy to access. – 36% say their records are all in one place– 32% believe they are mostly in one place and fairly easy to access– Close to one in four say they are in a number of different places or all over the place
• Meanwhile, a majority of Canadians see a relationship between where their records are stored and the type of care they receive.– A perceived positive impact (59%) outstrips a perceived negative impact (14%)
• Perhaps not surprising, those whose records are all over consider it having a negative impact on the care they receive
• Canadians are not quite convinced that the way in which their records are stored is a big problem for the health care system at large– 7% very big problem; 28% big problem
© Harris/Decima
Two in three believe their records are fairly easy to access; mostly in one place
Q2. What about the state, condition and location of your personal health care records? As far as you know are they…
2010
2012
0% 20% 40% 60% 80% 100%
38%
36%
32%
32%
12%
11%
10%
12%
8%
8%
All in one place and very easy to access Mostly in one place and fairly easy to access
In a number of different places and fairly difficult to access All over the place and very difficult to access
Don't know
Base: All respondents (n=1,010)
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A small majority believe how their records are maintained has a positive impact on the care they receiveQ3. Would you say the way your health care records are maintained has a very positive impact, a positive impact, no impact, a negative
impact, or a very negative impact on the kind of care you receive?
2010
2012
0% 20% 40% 60% 80% 100%
10%
10%
44%
48%
27%
21%
12%
12%
2%
3%
5%
6%
Very positive Positive No impact Negative Very negative Don't know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
2%
4%
12%
15%
8%
12%
12%
8%
10%
17%
25%
58%
60%
47%
52%
49%
47%
48%
21%
34%
20%
16%
23%
20%
19%
23%
21%
37%
31%
5%
3%
14%
9%
11%
12%
12%
17%
3%
4%
2%
3%
3%
3%
Perceptions of the impact of record storage on the type of care received increases with age; views vary by storage of medical records
Q3. Would you say the way your health care records are maintained has a very positive impact, a positive impact, no impact, a negative impact, or a very negative impact on the kind of care you receive?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
20%12%9%9%7%
16%10%11%8%8%8%
10%
57%46%
48%45%
44%63%
41%47%
52%51%
44%44%
48%
8%19%24%
24%27%
29%
19%18%
20%20%
31%24%
21%
7%13%
13%13%
10%5%
11%17%
9%12%
10%11%
12%
1%2%
2%3%
5%3%
3%4%1%3%2%
5%
3%
Very positive Positive No impact Negative Very negative
Base: All respondents (n=1,010)
© Harris/Decima
Less convinced that the maintenance of records is a big problem for the health care system
Q4. And would you say that the way personal health care records are maintained is a very big problem, a big problem, a small problem or no problem whatsoever for the Canadian health care system?
2010
2012
0% 20% 40% 60% 80% 100%
6%
7%
25%
28%
35%
31%
24%
23%
10%
11%
Very big problem Big problem Small problem No problem Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
21%
11%
4%
2%
7%
6%
7%
7%
7%
47%
48%
24%
22%
32%
26%
29%
27%
28%
24%
31%
39%
29%
30%
33%
32%
30%
31%
4%
7%
23%
35%
22%
25%
21%
25%
23%
3%
3%
9%
12%
9%
10%
11%
11%
11%
Likelihood of recognizing problem is related to storage of recordsQ4. And would you say that the way personal health care records are maintained is a very big problem, a big problem, a small problem or
no problem whatsoever for the Canadian health care system?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
4%9%
6%5%9%
2%
4%11%
6%6%
3%7%
7%
30%32%
33%26%22%
18%
31%34%
26%28%
27%23%
28%
26%30%
26%34%
39%41%
32%32%
28%34%
31%36%
31%
31%18%
25%22%
17%35%
21%16%
29%18%
25%22%
23%
10%12%10%
13%13%
3%
12%7%
11%14%14%12%
11%
Very big problem Big problem Small problem No problem Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
Those with easy access more convinced of the positive benefits
Base: All respondents (n=1,010)
All in one place and very easy to access
Mostly in one place and fairly easy to access
In a number of places and fairly difficult to access
All over the place and very difficult to access
Impact on Personal care 2012 2010 2012 2010 2012 2010 2012 2010
Positive 76% 72% 70% 62% 29% 17% 20% 18%
None 16% 23% 20% 27% 34% 36% 21% 26%
Negative 3% 1% 6% 7% 34% 40% 54% 52%
Impact on System 2012 2010 2012 2010 2012 2010 2012 2010
Very big/Big problem 24% 20% 28% 26% 59% 51% 69% 62%
Small/No Problem 64% 71% 62% 65% 38% 44% 28% 35%
© Harris/Decima
Awareness and Impressions of Electronic Record Transition
© Harris/Decima
Key Findings: Awareness and Impressions of Transition• Just over half of Canadians believe that there is a goal to convert health records from
paper to electronic.
• While overall awareness has not changed, there has been a marked increase in the receptivity to converting personal health records from paper to electronic.– 46% say this a very good idea in 2012 in comparison to 29% in 2010
• Generally, those with records in more places are stronger proponents of this idea
• The primary concern with this idea continues to focus on privacy and identify theft. That said, fewer in 2012 say they have a concern in comparison to 2010.
• There has been an increase in perceptions that their physician is using an electronic record system in their office.– 50% say this is the case in 2012 vs. 38% in 2010– The data suggests that current use of an electronic record by their physician does not have
an impact on the perceived value of it• 86% with an EMR say it is a good idea while 84% of those without one feel this way
© Harris/Decima
Half think there is a goal of converting paper records to electronicQ5. As far as you know, do we have a goal and a plan to convert all personal health care records in Canada from a paper format into an
electronic format?
2010
2012
0% 20% 40% 60% 80% 100%
49%
52%
29%
25%
22%
22%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
46%
44%
58%
53%
50%
56%
54%
50%
52%
36%
35%
19%
24%
30%
22%
23%
28%
25%
18%
21%
23%
23%
20%
22%
23%
22%
22%
Younger Canadians are less aware of a national goal to convert records Q5. As far as you know, do we have a goal and a plan to convert all personal health care records in Canada from a paper format into an
electronic format?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
48%53%56%55%
52%39%
49%54%56%
49%43%
48%
52%
24%23%
25%23%
26%40%
29%28%23%
27%27%
23%
25%
28%23%
19%21%22%21%
23%18%
21%25%
29%30%
22%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
Increase in receptivity to converting from paper to electronic recordsQ6. On balance, do you think that converting all personal health records from a paper format to an electronic format would be a very
good idea, a good idea, a poor idea or a very poor idea?
2010
2012
0% 20% 40% 60% 80% 100%
29%
46%
45%
39%
14%
8%
6%
4%
5%
3%
Very good idea Good idea Poor idea Very poor idea Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
54%
55%
48%
41%
43%
49%
44%
48%
46%
31%
33%
39%
42%
41%
37%
39%
38%
39%
10%
7%
7%
10%
9%
9%
10%
7%
8%
4%
2%
3%
5%
5%
2%
3%
4%
4%
Younger Canadians are the most receptive to the idea of an electronic format for health records
Q6. On balance, do you think that converting all personal health records from a paper format to an electronic format would be a very good idea, a good idea, a poor idea or a very poor idea?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
37%41%
50%44%
53%46%
42%53%
48%41%
31%40%
46%
41%41%
39%40%
33%51%
43%35%
37%40%
46%45%
39%
11%9%
6%10%
9%4%
9%7%
7%5%17%
9%
8%
5%7%3%4%
2%3%
3%9%
4%4%
4%
Very good idea Good idea Poor idea Very poor idea
Base: All respondents (n=1,010)
© Harris/Decima
Privacy continues to be the chief concern with electronic recordsQ7. Is there anything about having your health records in an electronic format that would concern you?
Don't know
No
Other
Selling/Commercial use of information
Information being misused/getting into wrong hands
Privacy/Identity Theft
0% 20% 40% 60% 80%
1%
52%
12%
3%
16%
31%
39%
25%
3%
20%
33%
2012 2010
Base: All respondents (n=1,010)
© Harris/Decima
Reported Use of Electronic Records in Doctor’s office has risenQ8. Does your principal doctor or care provider use an electronic record in their office?
2010
2012
0% 20% 40% 60% 80% 100%
38%
50%
44%
36%
18%
14%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
48%
46%
52%
51%
100%
53%
47%
50%
37%
43%
39%
35%
100%
37%
35%
36%
16%
11%
8%
15%
10%
18%
14%
There is significant variance by region on reported use of electronic records
Q8. Does your principal doctor or care provider use an electronic record in their office?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
55%49%
54%49%
46%43%
46%25%
55%48%
80%63%
50%
32%39%
37%41%
33%39%
44%58%
31%39%
10%25%
36%
13%13%
9%10%
22%17%
10%17%14%13%10%12%
14%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
Both those with and without electronic records feel that EHRs are a good idea
Base: All respondents (n=1,010)
Have EMR Don’t have EMR
EHRs are… 2012 2010 2012 2010
Good idea 86% 78% 84% 73%
Bad idea 12% 17% 13% 22%
© Harris/Decima
Awareness of Health System Usage
© Harris/Decima
Key Findings: Awareness of Health System Usage• As far as most Canadians believe, personal health information is not used for any other
purpose other than by their health care provider.
• Meanwhile, three in four Canadians believe that personal health records that are electronic could be used in more ways as compared to paper records.
• There has been a notable decline in Canadians’ awareness of the term “Health System Use or Secondary Uses”: now 18% from 34% in 2010.
• Four areas of health system usages were tested:• Using this information to improve front-line health care• Using this information to better track the health of the general population• Using this information to improve the efficiency and effectiveness of health care delivery to the public• Using this information to strengthen medical and health research
• The data suggests that there has been in an increase in positive perceptions on health system usages of data on the overall healthcare system.– Increase most noted in the “very positive” impressions, as well as positive impressions overall
(top 2 box scores)
© Harris/Decima
Key Findings: Awareness of Health System Usage (2)• A strong majority believe that Health System Usage of data will have a major or minor
impact on both the healthcare system and patient care.
• There has been a decline in the proportion of Canadians who are concerned about their individual information being used for HSU.– 14% very concerned (down 6 from 20% in 2010) and 22% somewhat concerned (down 7
from 29% in 2010)
• The data suggests that de-identifying information alleviates some concern about personal use of data for HSU.
• An increasing number of Canadians are comfortable with sharing de-identified information with organizations where Canadians see value in sharing the data, such as health care organizations, research, and statistics.
• There is very little comfort with private organizations, such as drug and insurance companies.
© Harris/Decima
There continues to be limited awareness of using health information for purposes other than providing care
Q9. As far as you know, is personal health information used for any purpose other than by your health care providers in giving care to an individual patient?
2010
2012
0% 20% 40% 60% 80% 100%
17%
14%
69%
73%
13%
12%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
A majority believe that electronic records can be used in more ways than paper records
Q10. Do you think that personal health information could be used in different or more ways if it was stored as an electronic record, as compared to a paper record?
2010
2012
0% 20% 40% 60% 80% 100%
70%
76%
22%
17%
8%
7%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
78%
83%
76%
73%
72%
80%
72%
80%
76%
14%
11%
19%
19%
23%
14%
19%
15%
17%
8%
6%
5%
8%
6%
6%
9%
5%
7%
Quebecers are less aware of multiple uses of electronic recordsQ10. Do you think that personal health information could be used in different or more ways if it was stored as an electronic record, as
compared to a paper record?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
68%75%76%79%
85%69%
84%62%
83%78%76%77%
76%
20%18%17%14%
12%31%
9%31%
12%15%
12%16%
17%
12%7%6%6%
3%
7%7%5%7%
12%7%
7%
Yes No Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
A decline in awareness the terms health system use or secondary usesQ11. Have you ever heard of Health System Use or Secondary Uses of patient health information?
2010
2012
0% 20% 40% 60% 80% 100%
34%
18%
64%
81%
Yes No
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
31%
18%
17%
16%
19%
17%
17%
19%
18%
69%
82%
82%
83%
80%
81%
82%
80%
81%
Younger Canadians least aware of Health System Use of informationQ11. Have you ever heard of Health System Use or Secondary Uses of patient health information?
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
16%20%20%18%17%
4%
18%17%17%16%20%18%
18%
81%79%79%81%81%
96%
81%81%81%83%77%82%
81%
Yes No
Base: All respondents (n=1,010)
© Harris/Decima
A sense that HSU has an impact on health care and patient careQ12-13. Knowing a little more about Health System or Secondary Use of this information, does this strike you as something that can have
a major impact, a minor impact or no real impact on the operation and quality of health care in Canada/on the kind of care you might receive as a patient?
Base: All respondents (n=1,010)
Health Care
2010
2012
0% 20% 40% 60% 80% 100%
55%
59%
29%
29%
11%
8%
6%
5%
Major impact Minor impact No real impact Don't know
Patient Care
2010
2012
0% 20% 40% 60% 80% 100%
42%
40%
36%
40%
17%
15%
5%
4%
© Harris/Decima
Overall increase in perceptions of benefits of HSU of information in a number of areas in health care
Q14-17. I’m going to read you a few more ways how health information from electronic records might be used for health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or
very negative impact on the operation and quality of health care in Canada.
Using this information to strengthen medical and health research
Using this information to improve the efficiency and effectiveness of health
care delivery to the public
Using this information to better track the health of the general population
Using this information to improve front-line health care
0% 20% 40% 60% 80% 100%
31%
33%
35%
39%
50%
51%
52%
49%
13%
12%
9%
8%
2%
2%
2%
1%
Very positive Positive Neutral Negative Very negative
Base: All respondents (n=1,010)
2012 2010
0% 20% 40% 60% 80% 100%
22%
24%
27%
32%
52%
54%
55%
49%
18%
14%
12%
12%
5%
5%
3%
3%
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
46%
51%
39%
34%
40%
42%
42%
35%
39%
44%
40%
51%
53%
49%
47%
47%
51%
49%
9%
4%
8%
8%
8%
8%
7%
9%
8%
1%
3%
1%
1%
2%
1%
1%
1%
1%
0.01
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
37%37%
42%50%
37%18%
29%38%39%
45%39%43%
39%
52%47%
49%39%
51%76%
67%50%50%41%
41%46%
49%
6%12%
7%9%
8%6%
3%5%
9%10%
12%10%
8%
3%1%1%1%
2%1%
1%2%
1%
1%
1%
2%
Very positive Positive Neutral Negative Very Negative
Some variance in perceived impact on front-line health careQ14. I’m going to read you a few more ways how health information from electronic records might be used for Health system or
secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or very negative impact on the operation and quality of health care in Canada.
Using this information to improve front-line health care.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
26%
38%
37%
31%
33%
36%
35%
30%
33%
54%
52%
47%
52%
49%
50%
49%
52%
51%
17%
9%
13%
11%
15%
11%
13%
12%
12%
2%
1%
1%
2%
1%
2%
1%
2%
2%
0.01
0.01
0.01
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
27%30%
37%36%37%
23%
32%33%35%35%
29%33%
33%
52%49%
49%54%
47%58%
53%51%49%
45%50%
55%
51%
13%13%
12%9%
12%19%
14%12%11%
15%13%
11%
12%
4%3%
1%1%
1%2%2%3%
1%
2%
3%
1%1%
1%
1%
Very positive Positive Neutral Negative Very Negative
Younger Canadians less likely to see very positive impacts on delivery of care to the public
Q15. I’m going to read you a few more ways how health information from electronic records might be used for Health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or
very negative impact on the operation and quality of health care in Canada.Using this information to improve the efficiency and effectiveness of health care delivery to the public.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
35%
37%
37%
34%
33%
38%
35%
35%
35%
49%
59%
54%
51%
54%
51%
53%
52%
52%
10%
2%
7%
10%
10%
7%
7%
11%
9%
0.05
0.02
0.03
0.02
0.02
0.03
0.02
0.02
1%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
31%32%
41%39%
36%12%
34%37%35%39%
32%35%
35%
56%55%
49%47%52%
71%
62%49%53%44%
54%54%
52%
6%9%6%
13%10%
11%
2%8%10%
13%10%
8%
9%
3%3%2%
1%1%
6%
4%2%
1%2%3%
2%
0.01
Very positive Positive Neutral Negative Very Negative
Younger Canadians less positive that HSU of information would be able to better track the health of the population
Q16. I’m going to read you a few more ways how health information from electronic records might be used for Health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or
very negative impact on the operation and quality of health care in Canada.Using this information to better track the health of the general population.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
35%
38%
29%
29%
31%
32%
29%
34%
31%
49%
46%
53%
52%
50%
49%
51%
49%
50%
13%
11%
14%
10%
13%
13%
14%
12%
13%
2%
3%
2%
3%
3%
2%
3%
2%
2%
1%
1%
1%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
25%29%
36%34%
26%43%
27%36%
32%23%
29%26%
31%
55%51%
47%49%
53%39%
59%48%
50%56%47%
46%
50%
10%14%12%15%
17%8%
11%8%13%
15%17%
22%
13%
5%2%2%
1%10%
1%3%
2%
2%5%
2%
1%
1%
2%
Very positive Positive Neutral Negative Very Negative
Younger Canadians most likely to see a very positive impact on HSU of information for strengthening medical and health research
Q17. I’m going to read you a few more ways how health information from electronic records might be used for Health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or
very negative impact on the operation and quality of health care in Canada.Using this information to strengthen medical and health research.
Base: All respondents (n=1,010)
© Harris/Decima
Decline in personal concern of using health information for HSUQ18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health
information being used for these types of Health System Uses?
2010
2012
0% 20% 40% 60% 80% 100%
20%
14%
29%
22%
25%
33%
23%
30%
Very concerned Somewhat concerned Not very concerned Not concerned at all
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
17%
9%
12%
16%
15%
13%
16%
11%
14%
19%
23%
22%
21%
25%
22%
23%
22%
22%
34%
34%
35%
33%
33%
33%
31%
36%
33%
28%
31%
30%
29%
26%
30%
28%
31%
30%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
14%16%16%
10%11%9%
8%10%
16%17%
10%18%
14%
20%24%23%
22%21%23%
30%18%
23%20%
29%20%
22%
27%32%35%
30%40%
32%
27%42%
28%30%
35%38%
33%
36%27%26%
35%28%
36%
32%28%32%33%
26%24%
30%
Very concerned Somewhat concerned Not very concerned Not concerned at all
Quebecers less concerned with secondary use of their informationQ18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health
information being used for these types of Health System Uses?
Base: All respondents (n=1,010)
© Harris/Decima
De-identifying information further reduces concern of system usage of information
Q19. If your health information was de-identified, would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about it being used for Health system purposes?
2010
2012
0% 20% 40% 60% 80% 100%
15%
14%
19%
15%
26%
28%
39%
42%
Very concerned Somewhat concerned Not very concerned Not concerned at all
Base: All respondents (n=1,010)
© Harris/Decima
De-identifying information further reduces concern of system usage of information
Q18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health information being used for these types of Health System Uses?
Q19. If your health information was de-identified, would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about it being used for Health system purposes?
De-identifying information
Initial concern with sharing information
0% 20% 40% 60% 80% 100%
14%
14%
15%
22%
28%
33%
42%
30%
Very concerned Somewhat concerned Not very concerned Not concerned at all
Base: All respondents (n=1,010)
© Harris/Decima
Relationship exists between initial concern of using information and concern if information is de-identified
Q18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health information being used for these types of Health System Uses?
Q19. If your health information was de-identified, would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about it being used for Health system purposes?
Not concerned at all
Not very concerned
Somewhat concerned
Very concerned
0% 20% 40% 60% 80% 100%
4%
6%
20%
48%
9%
27%
48%
24%
34%
51%
16%
19%
52%
15%
15%
7%
Very concerned Somewhat concerned Not very concerned Not concerned at all
Base: All respondents (n=1,010)
© Harris/Decima
Little comfort with sharing de-identified information with private organizations
Q20-24. How would you feel about sharing your de-identified health information with the following organizations?
Private organizations such as drug companies or insurance companies
Your provincial government department of health
Statistical organizations such as Statistics Canada or the Canadian Institute for Health Information
Research organizations such as a University
Other health care organizations such as hospitals and regional health authorities
0% 20% 40% 60% 80% 100%
8%
36%
37%
39%
42%
21%
43%
43%
40%
43%
28%
12%
11%
12%
10%
42%
8%
8%
8%
5%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortableBase: All respondents (n=1,010)
2012 2010
0% 20% 40% 60% 80% 100%
7%
32%
34%
30%
33%
20%
40%
43%
42%
41%
28%
17%
14%
16%
17%
44%
10%
7%
11%
7%
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
40%
40%
39%
34%
30%
41%
36%
36%
36%
38%
42%
44%
43%
45%
42%
43%
43%
43%
13%
15%
12%
12%
16%
9%
13%
12%
12%
10%
3%
5%
10%
7%
8%
8%
8%
8%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
32%29%33%
41%44%
41%
33%33%
40%36%
24%41%
36%
41%47%
46%40%
40%43%
45%52%37%43%
49%38%
43%
13%10%
15%16%9%12%
10%10%
13%12%
13%15%
12%
12%14%
6%4%
5%5%
11%4%
9%9%
11%6%
8%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Albertans less comfortable with de-identified health information being shared with their provincial department of health
Q20. How would you feel about sharing your de-identified health information with the following organizations?Your provincial government department of health
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
41%
44%
46%
40%
36%
46%
41%
43%
42%
43%
44%
41%
42%
47%
40%
43%
44%
43%
10%
11%
9%
10%
11%
9%
10%
9%
10%
0.05
0.04
0.06
0.05
0.04
0.05
0.04
0.05
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
38%36%
43%43%47%50%
46%36%
44%38%
43%45%
42%
44%48%
44%41%
42%32%
41%49%
41%39%
40%45%
43%
11%10%
8%11%
6%18%
9%10%9%
17%11%
7%
10%
6%5%5%5%5%
3%3%6%5%6%2%
5%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Those with an EMR more comfortable with sharing information locallyQ21. How would you feel about sharing your de-identified health information with the following organizations?
Other health care organizations such as hospitals and regional health authorities.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
42%
47%
42%
35%
35%
42%
38%
40%
39%
37%
38%
42%
39%
43%
38%
41%
39%
40%
13%
9%
9%
15%
14%
9%
12%
13%
12%
8%
5%
7%
9%
7%
10%
8%
8%
8%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
37%33%
41%42%
37%51%
30%41%
37%38%42%43%
39%
39%37%
40%39%
45%31%
42%46%
40%41%33%33%
40%
14%15%
14%10%9%13%
17%9%
12%11%
15%16%
12%
8%14%
5%9%9%5%
10%3%
11%11%10%6%
8%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Youth most comfortable with sharing information for researchQ22. How would you feel about sharing your de-identified health information with the following organizations?
Research organizations such as a University.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
36%
45%
38%
35%
32%
39%
38%
36%
37%
49%
36%
44%
42%
45%
43%
42%
45%
43%
9%
14%
10%
13%
14%
10%
12%
11%
11%
5%
5%
7%
9%
8%
7%
8%
7%
8%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
33%31%
39%37%
42%40%
33%35%
40%35%33%
39%
37%
39%43%
47%43%
47%41%
45%48%42%
36%48%38%
43%
16%13%
9%11%
7%14%
12%11%
10%18%
8%14%
11%
11%11%
4%9%
5%5%
9%4%8%
11%9%7%
8%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Older Canadians slightly less comfortable with sharing de-identified information with statistical organizations
Q23. How would you feel about sharing your de-identified health information with the following organizations?Statistical organizations such as Statistics Canada or the Canadian Institute for Health Information.
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
8%
10%
10%
7%
8%
6%
7%
8%
8%
22%
21%
18%
25%
22%
22%
24%
19%
21%
25%
30%
31%
27%
28%
29%
30%
26%
28%
44%
39%
42%
40%
41%
43%
38%
47%
42%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
5%7%8%
5%10%13%
8%10%8%7%
3%5%
8%
16%16%
22%29%
24%22%
25%23%
22%22%
17%18%
21%
31%31%
28%24%28%
23%
23%32%
27%26%
31%25%
28%
47%46%41%41%
38%41%
43%34%
43%45%49%
50%
42%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Comfort with private organizations having de-identified health information decreases with age
Q24. How would you feel about sharing your de-identified health information with the following organizations?Private organizations such as drug companies or insurance companies.
Base: All respondents (n=1,010)
© Harris/Decima
There is no consensus on who should control sharing information Q25-26. If your information was used in this way, and was shared with other doctors, hospitals and health researchers, who do you think
would/who would you prefer to have control of these data and make that decision?
Don't Know
Your hospital or health care organization
Your provincial government
Your doctor
You
0% 20% 40% 60% 80%
1%
8%
11%
35%
44%
6%
9%
26%
29%
30%
Would have control Would prefer to have control
Base: All respondents (n=1,010)
0% 20% 40% 60% 80%
1%
11%
11%
33%
44%
4%
12%
25%
29%
30%
2012 2010
© Harris/Decima
No agreement on comfort with using identified information to track how well treatments were working
Q27. In rare cases, the use of your personal health information may contain your name or address. For example, if a doctor doing research needed to track the health of individuals to determine how well different treatments were working. Would you feel very
comfortable, somewhat comfortable, somewhat uncomfortable or very uncomfortable if your identified health information was used in this way?
2010
2012
0% 20% 40% 60% 80% 100%
13%
15%
32%
35%
29%
28%
24%
20%
Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable
Base: All respondents (n=1,010)
© Harris/Decima
Comparison of Comfort/Concern about the General Concept of HSU vs. De-Identified vs. Identified Uses (top 2 box scores)
Identified use (Q27)
General concept (Q18)
De-identified use (Q19)
0% 20% 40% 60% 80% 100%
46%
48%
65%
50%
63%
70%
2012 2010
Base: All respondents (n=1,010)
© Harris/Decima
Two in three continue to insist on requiring consent to use identified information
Q28. In cases like this, where you were identified, how would you feel about a requirement that your personal approval or consent would have to be given before your health information was used? Is this something that you insist upon, you would prefer but not insist upon or
something that you wouldn’t be concerned about and would not require your personal approval or consent?
2010
2012
0% 20% 40% 60% 80% 100%
67%
66%
22%
26%
9%
7%
Something I would insist upon Something I would prefer, but not insist upon Something I wouldn’t be concerned about
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
63%
64%
67%
66%
71%
65%
67%
65%
66%
28%
31%
28%
24%
24%
28%
25%
27%
26%
8%
5%
5%
8%
5%
6%
7%
7%
7%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
58%69%69%73%
68%53%
64%60%
66%65%69%
77%
66%
31%25%24%
22%24%
38%
23%30%
27%25%
25%19%
26%
9%5%7%3%8%9%
12%8%6%
10%5%4%
7%
Something I would insist upon Something I would prefer, but not insist upon Something I wouldn’t be concerned about
Those in BC most insistent on consentQ28. In cases like this, where you were identified, how would you feel about a requirement that your personal approval or consent would have to be given before your health information was used? Is this something that you insist upon, you would prefer but not insist upon or
something that you wouldn’t be concerned about and would not require you personal approval or consent?
Base: All respondents (n=1,010)
© Harris/Decima
Three in four claim that they would give their consent for HSU of information
Q29. And if your approval or consent was required before your identified information could be used for health system purposes, do you think you would give your approval or consent or you would not give your approval or consent?
2010
2012
0% 20% 40% 60% 80% 100%
69%
77%
21%
13%
11%
10%
I would give my approval or consent I would NOT give my approval or consent Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
76%
84%
79%
76%
74%
80%
76%
79%
77%
12%
9%
14%
13%
17%
10%
14%
11%
13%
12%
7%
7%
11%
9%
10%
10%
10%
10%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
74%68%
79%81%83%
89%
85%76%77%
73%78%77%
77%
13%18%
9%15%9%
6%
9%17%
11%19%8%12%
13%
13%14%11%
4%9%5%
6%7%
12%8%
14%11%
10%
I would give my approval or consent I would NOT give my approval or consent Don't Know
Atlantic and younger Canadians most apt to give consent for health system uses of their information
Q29. And if your approval or consent was required before your identified information could be used for health system purposes, do you think you would give your approval or consent or you would not give your approval or consent?
Base: All respondents (n=1,010)
© Harris/Decima
An increase in the number who would be more comfortable with an assessment process
Q30. Would you be more comfortable if you knew that the research project seeking to use identified information would have to go through an assessment process and be approved by an independent agency that would examine the potential risk to your privacy?
2010
2012
0% 20% 40% 60% 80% 100%
65%
71%
33%
26%
Yes, oversight adds comfort No, it makes no difference
Base: Those who insist on approval or consent before their health information was used or would not give approval for their identified information to be used (n=700)
© Harris/Decima
There has been an increase in the number of Canadians who would insist on providing consent and say that they would grant it
Base: All respondents (n=1,010)
Insist on Consent Prefer Consent Wouldn’t care
2012 2010 2012 2010 2012 2010
Would grant 74% 64% 88% 77% 77% 81%
Would not grant 14% 22% 7% 15% 18% 18%
Don’t Know 12% 13% 5% 7% 5% 1%
© Harris/Decima
There is a growing number that views consent as adding comfort
Insist on Consent Prefer Consent Wouldn’t care
2012 2010 2012 2010 2012 2010
Oversight adds comfort
72% 67% 63% 40% 54% 39%
Makes no difference
25% 31% 37% 55% 42% 57%
Base: Those who insist on approval or consent before their health information was used or would not give approval for their identified information to be used (n=700)
© Harris/Decima
There has been a decline in the number who would not grant consent
Would insist on consent and would not grant
Would insist on consent and oversight would not add comfort
0% 5% 10% 15% 20% 25% 30%
15%
21%
9%
17%
2012 2010
Base: All respondents (n=1,010)
© Harris/Decima
A strong majority expect their provider to notify them when their information is being used
Q31. Would you expect your doctor or care provider to notify you about when and how your personal information was being used for Health system purposes?
2010
2012
0% 20% 40% 60% 80% 100%
87%
86%
12%
13%
Yes, I would expect this No, I would not expect this
Base: All respondents (n=1,010)
© Harris/Decima
On balance, half think HSU of de-identified information outweighs privacy concerns
Q32. Overall and on balance, what’s more important to you? Protecting the privacy of your health information or being able to use this de-identified information for Health system uses?
2010
2012
0% 20% 40% 60% 80% 100%
41%
56%
54%
39%
5%
5%
Being able to use this de-identified information for Health system uses Protecting the privacy of my health information Don't Know
Base: All respondents (n=1,010)
© Harris/Decima
All over the place
Different places
Mostly in one place
All in one place
Don't have EMR
Have EMR
Female
Male
Total
0% 20% 40% 60% 80% 100%
58%
56%
60%
53%
49%
61%
57%
56%
56%
39%
36%
38%
42%
47%
34%
39%
40%
39%
3%
8%
2%
5%
4%
5%
5%
4%
5%
65+55-6445-5435-4425-3418-24
Atl.QCON
MB/SKABBC
Total
0% 20% 40% 60% 80% 100%
58%51%55%
52%59%
86%
57%59%
55%58%56%54%
56%
35%46%41%
41%41%
8%
40%37%
40%38%40%
41%
39%
7%3%4%
6%
6%
3%4%5%5%4%5%
5%
Being able to use this de-identified information for Health system usesProtecting the privacy of my health informationDon't Know
18 to 24 year olds most apt to place more importance on using de-identified information for health systems uses than on privacy
Q32. Overall and on balance, what’s more important to you? Protecting the privacy of your health information or being able to use this de-identified information for Health system uses?
Base: All respondents (n=1,010)
© Harris/Decima
Thank you.
© Harris/Decima